DRUG ABUSE TREATMENT UNDER MANAGED CARE--ROLE OF PPOS

描述：（申请人摘要） 本研究的主要目的是了解药物滥用服务如何 在首选提供商组织（PPO）中提供，并对 决定在内部或通过分拆提供这些服务 与专业供应商签订合同。 本研究的具体目的包括以下几个方面：1. 描述 从几个因素来看，在私人诊所提供药物滥用服务， 包括总体规划和市场特点， 药物滥用服务本身与供应商签订合同， 治疗方法、支付方式和风险分担、利用 管理，提供者选择，进入治疗，福利设计，以及 质量保证。 2. 记录如何提供药物滥用服务， PPO随时间的推移而变化，并探讨哪些因素影响这些变化。 3. 模拟为什么一些PPO在计划内提供药物滥用服务 和其他私人专业组织选择将药物滥用服务外包给 专业管理的行为健康护理组织。 审题 关于这三个具体目标，我们将进行初步电话 大约三年后，又对30个国家的240个专业人员组织进行了一次调查， 市场领域。 我们将与全国范围内的纵向合作， 社区跟踪研究（CTS）由中心进行， 研究卫生系统的变化和资助的罗伯特伍德约翰逊 基金会 在与CTS相同的30个市场领域以及次年 他们的健康计划调查，我们将调查相同的PPO样本 （根据他们如何提供药物滥用分为两组） 通过直接维护网络或通过与 专业供应商。 同样，我们的第二波调查将协调 并对CTS第二波健康计划调查进行跟踪。 拟议的药物滥用治疗服务研究是第一个将联合收割机 对市场区域内的PPO进行全国性调查， 将使我们能够跟踪在私人诊所提供药物滥用服务的情况， 在不断变化的医疗保健市场中发展。 本研究将提供 关于这些变化的性质和程度的系统信息。

DESCRIPTION: (Applicant's Abstract) The main objective of this study is to understand how drug abuse services are provided in preferred provider organizations (PPOs) and to model decisions to provide these services internally or through a carve-out contract with a specialty vendor. The specific aims for this study include the following: 1. Describe the provision of drug abuse services in PPOs in terms of several factors, including overall plan and market characteristics, and characteristics of the drug abuse services themselves in terms of contracting with vendors, treatment approaches, payment methods and risk sharing, utilization management, provider selection, entry into treatment, benefit design, and quality assurance. 2. Document how the provision of drug abuse services in PPOs changes over time and explore what factors influence these changes. 3. Model why some PPOs provide drug abuse services internally within the plan and other PPOs choose to carve-out drug abuse services to be delivered by a specialty managed behavioral health care organization. To examine questions related to these three specific aims, we will conduct an initial telephone survey and another survey approximately three years later of 240 PPOs in 30 market areas. We will collaborate with the longitudinal, nationally representative Community Tracking Study (CTS) conducted by the Center for Studying Health System Change and funded by the Robert Wood Johnson Foundation. In 30 of the same market areas as CTS and in the year following their health plan survey, we will survey a sample of the same PPOs (stratified into two groups according to how they provide drug abuse services by maintaining a network directly or through contracts with a specialty vendor. Similarly, the second wave of our survey will coordinate and follow-up on the second wave of the CTS survey of health plans. The proposed study of drug abuse treatment services is the first to combine a national survey of PPOs within market areas with a prospective design that will allow us to track how the delivery of drug abuse services in PPOs evolves within the changing health care market. This study will provide systematic information on the nature and extent of these changes.